1.Associations of active and passive tobacco exposure with elevated blood pressure in Korean adolescents
Hyerin PARK ; Hyunsuk JEONG ; Hyeon Woo YIM ; Sanghyuk BAE
Epidemiology and Health 2024;46(1):e2024028-
OBJECTIVES:
To test the hypothesis that tobacco exposure is associated with elevated blood pressure (EBP) in Korean adolescents, and that the association is dose dependent.
METHODS:
This cross-sectional study used data from the 2011-2020 Korea National Health and Nutrition Survey (KNHANES). Subjects were eligible if they were 13-18 years at the time of participation in KNHANES. Tobacco exposure was defined by urine cotinine level. The main outcomes were EBP and hypertension. Statistical analyses were conducted using SAS version 9.4 with appropriate sampling weights to account for the complex survey design, stratification, and cluster variable.
RESULTS:
A total of 2,518 adolescents was included in the analysis, representing 2.5 million Korean adolescents. The mean± standard deviation participant age was 15.3±1.7 years, and 55.3% were male. The number of participants with active tobacco smoke exposure was 283 (11.2%), passive tobacco smoke exposure was 145 (5.8%), and no smoke exposure was 2,090 (83.0%). Analysis of the 2,518 urine-cotinine-verified participants showed that tobacco smoke exposure had a significant effect on EBP: with an odds of elevated blood pressure of 3.00 (95% confidence interval [CI], 1.14 to 7.89). The odds of hypertension were 3.61 (95% CI, 1.13 to 11.49) in the active smoking group compared with the no tobacco exposure group after adjustment for potential confounders.
CONCLUSIONS
It is necessary to present a range of public health plans to reduce tobacco exposure that affects adolescents’ blood pressure, and further research with a larger number of participants using urine cotinine as a biomarker is needed.
3.Latent Tuberculosis Infection Screening and Treatment in Congregate Settings (TB FREE COREA):Demographic Profiles of InterferonGamma Release Assay Cohort
Hyung Woo KIM ; Jinsoo MIN ; Joon Young CHOI ; Ah Young SHIN ; Jun-Pyo MYONG ; Yunhee LEE ; Hyeon Woo YIM ; Hyunsuk JEONG ; Sanghyuk BAE ; Eunhye SHIM ; Hyekyung IN ; Chaemin CHUN ; Gahee KIM ; Ji Young KANG ; Sung-Soon LEE ; Jae Seuk PARK ; Ju Sang KIM
Journal of Korean Medical Science 2021;36(36):e246-
In 2017, the Korean government launched an unprecedentedly large-scaled latent tuberculosis infection (LTBI) screening project which covered more than a million individuals in congregate settings. A total of 1,047,689 participants of source population (n = 2,336,157) underwent LTBI testing from 2017 to 2018. The overall LTBI test uptake rate during this project was 44.8%. Workers in daycare centers (83.5%) and kindergartens (78.9%) showed high participation rate. A total of 1,012,206 individuals with valid results of interferongamma release assay (IGRA) were selected to constitute the IGRA cohort. Most of the enrolled participants in the IGRA cohort were in their working age. Approximately, threequarters of total enrolled population were female. Investigating the LTBI prevalence, stages of LTBI care cascade, natural history of LTBI, efficacy of LTBI treatment and cost-effectiveness of LTBI screening are feasible within this IGRA cohort.
4.Latent Tuberculosis Infection Screening and Treatment in Congregate Settings (TB FREE COREA):Demographic Profiles of InterferonGamma Release Assay Cohort
Hyung Woo KIM ; Jinsoo MIN ; Joon Young CHOI ; Ah Young SHIN ; Jun-Pyo MYONG ; Yunhee LEE ; Hyeon Woo YIM ; Hyunsuk JEONG ; Sanghyuk BAE ; Eunhye SHIM ; Hyekyung IN ; Chaemin CHUN ; Gahee KIM ; Ji Young KANG ; Sung-Soon LEE ; Jae Seuk PARK ; Ju Sang KIM
Journal of Korean Medical Science 2021;36(36):e246-
In 2017, the Korean government launched an unprecedentedly large-scaled latent tuberculosis infection (LTBI) screening project which covered more than a million individuals in congregate settings. A total of 1,047,689 participants of source population (n = 2,336,157) underwent LTBI testing from 2017 to 2018. The overall LTBI test uptake rate during this project was 44.8%. Workers in daycare centers (83.5%) and kindergartens (78.9%) showed high participation rate. A total of 1,012,206 individuals with valid results of interferongamma release assay (IGRA) were selected to constitute the IGRA cohort. Most of the enrolled participants in the IGRA cohort were in their working age. Approximately, threequarters of total enrolled population were female. Investigating the LTBI prevalence, stages of LTBI care cascade, natural history of LTBI, efficacy of LTBI treatment and cost-effectiveness of LTBI screening are feasible within this IGRA cohort.
5.Latent Tuberculosis Cascade of Care Among Healthcare Workers:A Nationwide Cohort Analysis in Korea Between 2017 and 2018
Jinsoo MIN ; Hyung Woo KIM ; Joon Young CHOI ; Ah Young SHIN ; Ji Young KANG ; Yunhee LEE ; Jun-Pyo MYONG ; Hyunsuk JEONG ; Sanghyuk BAE ; Hyeon-Kyoung KOO ; Sung-Soon LEE ; Jae Seuk PARK ; Hyeon Woo YIM ; Ju Sang KIM
Journal of Korean Medical Science 2022;37(20):e164-
Background:
In 2017, Korea implemented nationwide latent tuberculosis infection (LTBI) project targeting healthcare workers (HCWs). We aimed to assess its performance using the cascade of care model.
Methods:
We included 45,503 employees of medical institutions with positive interferongamma release assay result who participated between March 2017 and December 2018. We described percentages of LTBI participants completing each step in the cascade of care.Poisson regression model was conducted to assess individual characteristics and factors associated with not-visiting clinics for further care, not-initiating LTBI treatment, and notcompleting treatment.
Results:
Proportions of visiting clinics and initiating and completing treatment in HCWs were 54.9%, 38.5%, and 32.0%, respectively. Despite of less likelihood of visiting clinics and initiating LTBI treatment, older age ≥ 65 years were more likely to complete treatment (adjusted relative risk [aRR], 0.80; 95% confidence interval [CI], 0.64–0.99), compared to young age < 35 years. Compared to nurses, doctors were less likely to visit clinic; however, were more likely to initiate treatment (aRR, 0.88; 95% CI, 0.81–0.96). Those who visited public health centers were associated with not-initiating treatment (aRR, 1.34; 95% CI, 1.29–1.40). When treated at private hospitals, 9-month isoniazid monotherapy was less likely to complete treatment, compared to 3-month isoniazid and rifampicin combination therapy (aRR, 1.33; 95% CI, 1.16–1.53).
Conclusion
Among employees of medical institutions with LTBI, only one third completed treatment. Age, occupation, treatment center, and initial regimen were significantly related to LTBI treatment performance indicators. Rifampicin-based short treatment regimens were effective under standard of care.